The dissolution of urinary mucus after cystoplasty

Three agents have been tested for mucolytic activity to prevent or treat difficulties in bladder emptying following augmentation and substitution cystoplasty, particularly in patients emptying by intermittent self-catheterisation. Carbocysteine produced precipitation of mucus, which was found not to be helpful. N-acetylcysteine and urea both dissolved mucus, but urea proved to be more effective.     

The effects of alkyl-lysophospholipids on leukemic cell lines. I. Differential action on two human leukemic cell lines, HL60 and K562

The action of an alkyl-lysophospholipid (ALP), ET180CH3, on clonogenicity, 3H-TdR uptake, and cell numbers was tested in two human leukemic cell lines, HL60 and K562, and short-term human leukemic bone marrow cultures. ALP eliminated clonogenicity in HL60 but not in K562 cultures; 3H-TdR uptake and cell numbers were depressed at low concentrations of ET180CH3 in HL60, but not K562 cultures. The action of the lysophospholipid analog on human leukemic bone marrow short-term cultures at low concentrations was similar to its action on HL60 cultures; clonogenicity and 3H-TdR uptake were depressed, but cell numbers were not significantly affected. The demonstration of differential action of ALP on two cell lines should significantly simplify the investigation of the mechanism of the reported differential action of ET180CH3 on normal and leukemic cell membranes.     

Intravenous immunoglobulin in the management of hemolytic disease of the newborn

Jaundice caused by hemolysis continues to challenge practitioners caring for infants in the NICU. Bilirubin levels can rise quickly in the first days of life, and interventions must be prompt to prevent side effects related to hyperbilirubinemia. Conventional treatments such as hydration and phototherapy are common, but new studies suggest that use of intravenous immunoglobin (IVIG) as an additional treatment may prevent the need for exchange transfusion in some babies. This article presents a case study of an infant with blood-type incompatibility treated successfully with multiple doses of IVIG, discusses the pathophysiology and clinical presentation of hemolytic jaundice, and reviews current management strategies for this disease.     

The morbidity of buccal mucosal graft harvest for urethroplasty and the effect of nonclosure of the graft harvest site on postoperative pain

PURPOSE: We assess the medium and long-term morbidity of buccal mucosal graft (BMG) harvest for urethroplasty, and evaluate the effect of nonclosure of the graft harvest site on postoperative pain. MATERIALS AND METHODS: A questionnaire was mailed to 110 men who underwent BMG urethroplasty between January 1, 1997 and August 31, 2002. Demographic data and side effects of BMG harvest, including oral pain, sensation and intake, were assessed postoperatively. A prospective study was then performed to compare 20 unselected men whose BMG donor site was closed with a group of 20 men in whom it was left open using a 5-point analog pain score that was completed twice daily for the first 5 postoperative days. RESULTS: A total of 49 men with a median age of 49 years (range 23 to 73) returned questionnaires relating to 57 BMG harvests. Of the graft harvests 47 (83%) were associated with postoperative pain, which was worse than expected in 24 (51%). Of the 57 patients 51 (90%) resumed oral liquid intake within 24 hours and 44 (77%) resumed normal diet within 1 week. Postoperative side effects included perioral numbness in 39 (68%) patients with 15 (26%) having residual numbness after 6 months, initial difficulty with mouth opening in 38 (67%) with 5 (9%) having persistent problems, changes in salivation in 6 (11%) and mucous retention cyst that required excision in 1 (2%). The men in the prospective donor site study had a median age of 51 years (range 24 to 70). Mean pain score for patients with donor site closure was 3.68 and was significantly higher than that for patients without donor site closure (2.26, p < 0.01). CONCLUSIONS: Buccal mucosal graft harvest is not a pain-free procedure. Closure of the harvest donor site appears to worsen this pain and it may be best to leave harvest sites open. The main long-term complications are perioral numbness, persistent difficulty with mouth opening and change in salivary function.     

Infant joint attention skill and preschool behavioral outcomes in at-risk children

This study examined whether infant joint attention (JA) skills predicted social behaviors in a sample of at-risk preschool children (n = 30) with a history of prenatal exposure to cocaine. JA behaviors were assessed with the Early Social and Communication Scales at 12, 15, and 18 months of age. Three classes of JA were measured: Initiating JA (IJA), Responding to JA (RJA), and Requests. Behavioral outcomes were measured at 36 months and included ratings of disruptive and withdrawn behaviors and social competence. JA behaviors were related to behavioral outcomes after controlling for language and cognitive ability. The functionally distinct uses of JA were differentially related to behavioral outcome. IJA negatively predicted disruptive behaviors, whereas Requests positively predicted disruptive behaviors. Infant RJA negatively predicted withdrawn behaviors and positively predicted social competence. These results are interpreted in the context of competing theories that attempt to explain variability in the expression of JA skills in the second year of life.